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Intraventricular reservoir application in neonates with progressive hydrocephalus

Year 2013, Volume: 48 Issue: 3, 200 - 203, 01.10.2013

Abstract

Aim: Controlled removal of cerebrospinal fluid by serial tapping of ventricular reservoir is an effective way to decompress the ventricular system while awaiting optimal conditions for permanent cerebrospinal fluid drainage through a ventriculo peritoneal shunt The aim of our study is to present our experience on patients for whom a ventricular reservoir was placed because of progressive hydrocephalus Material and Method: The record of 18 patients who were born between 2005 2009 and diagnosed with progressive hydrocephalus for whom a ventricular reservoir was placed was reviewed retrospectively The indications and complications and the need for ventriculo peritoneal shunt are documented Results: Among the 18 patients 13 were preterm mean birth weight 1542 plusmn;522 g; mean gestational age 29 9 plusmn;3 4 weeks 5 were determined as term mean birth weight 3270 plusmn;679 g; mean gestational age 38 plusmn;0 7 weeks The etiology of hydrocephalus was intraventricular hemorrhage in 11 meningomyelocele in 4 congenital hydrocephalus in 3 patients Mean insertion time of the reservoir was 21 5 days range 7 71 days of birth while the mean follow up period with reservoir was 31 5 days range 7 122 days Ventriculo peritoneal shunt was placed to 16 infants 88 Complications related to the reservoir were skin infection in one patient and skin necrosis in one patient Three babies with intraventricular hemorrhage and one baby with congenital hydrocephalus and muscular disease died due to aspiaration pneumonia in the postneonatal period and the other baby with congenital hydrocephalus died due to multiorgan failure Conclusions: Ventricular reservoir placement is an effective procedure for cerebrospinal fluid drainage in cases of progressive hydrocephalus Our study demonstrates that ventricular reservoir is a better alternative than serial lumbar punctures to prevent permanent damage secondary to progressive hydrocephalus on brain parenchyme in those babies when ventriculoperitoneal shunt insertion is not possible Turk Arch Ped 2013; 48: 200 203

References

  • Kirkpatrick M, Engleman H, Minns RA. Symptoms and signs of progressive hydrocephalus. Arch Dis Child 1989; 64(1): 124-8.
  • Levene MI. Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child 1981; 56(12): 900-4.
  • Levene MI, Starte DR. A longitudinal study of post-haemorrhagic ventricular dilatation in the newborn. Arch Dis Child 1981; 56(12): 905Kreusser KL, Tarby TJ, Kovnar E, Taylor DA, Hill A, Volpe JJ. Serial lumbar punctures for at least temporary amelioration of neonatal posthemorrhagic hydrocephalus. Pediatrics 1985; 75(4): 713Randomised trial of early tapping in neonatal posthaemorrhagic ventricular dilatation. Ventriculomegaly Trial Group. Arch Dis Child 1990; 65(1): 3-10.
  • Marlin AE, Gaskill SJ. The etiology and management of hydrocephalus in the preterm infant. Concepts Pediatr Neurosurg 1990; 3: 67-78.
  • Rhodes TT, Edwards WH, Saunders RL, et al. External ventricular drainage for initial treatment of neonatal posthemorrhagic hydrocephalus: surgical and neurodevelopmental outcome. Pediatr Neurosci 1987; 13(5): 255-62.
  • Weninger M, Salzer HR, Pollak A, et al. External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery 1992; 31(1): 52-8.
  • Marlin AE, Rivera S, Gaskill SJ. Treatment of post-hemorrhagic ventriculomegaly in the preterm infant: Use of the subcutaneous ventricular reservoir. Concepts Pediatr Neurosurg 1988; 8: 15-22.
  • McComb JG, Ramos AD, Platzker AC, Henderson DJ, Segall HD. Management of hydrocephalus secondary to intraventricular hemorrhage in the preterm infant with a subcutaneous ventricular catheter reservoir. Neurosurgery 1983; 13(3): 295-300.
  • Volpe JJ. Intracranial hemorrhage: Germinal matrix-intraventricular hemorrhage of the premature infant. In: Volpe JJ, (ed): Neurology of the newborn. Philadelphia: Saunders, 1995: 403-63.
  • Yu B, Li S, Lin Z, Zhang N. Treatment of posthemorrhagic hydrocephalus in premature infants with subcutaneous reservoir drainage. Pediatr Neurosurg 2009; 45(2): 119-25.
  • Boynton BR, Boynton CA, Merritt TA, Vaucher YE, James HE, Bejar RF. Ventriculoperitoneal shunts in low birth weight infants with intracranial hemorrhage: neurodevelopmental outcome. Neurosurgery 1986; 18(2): 141-5.
  • Weiss MG, Ionides SP, Anderson CL. Meningitis in premature infants with respiratory distress: role of admission lumbar puncture. J Pediatr 1991; 119(6); 973-5.
  • Willis B, Javalkar V, Vannemreddy P, et al. Ventricular reservoirs and ventriculoperitoneal shunts for premature infants with posthemorrhagic hydrocephalus: an institutional experience. J Neurosurg Pediatr 2009; 3(2): 94-100.
  • Hahn YS, McClone DG, Raimondi AJ, et al. Surgical severe periventricular intraventricular hemorrhage and posthemorrhagic hydrocephalus. In: American Society of Pediatric Neurosurgery, (ed). Concepts in Pediatric Neurosurgery 1983; 66-80.
  • Hudgins RJ, Boydston WR, Gilreath CL. Treatment of posthemorrhagic hydrocephalus in the preterm infant with a ventricular access device. Pediatr Neurosurg 1998; 29(6): 309-13.
  • Kormanik K, Praca J, Garton HJ, Sarkar S. Repeated tapping of ventricular reservoir in preterm infants with post-hemorrhagic ventricular dilatation does not increase the risk of reservoir infection. J Perinatol 2010; 30(3): 218-21.
  • Smith KM, Deddish RB, Ogata ES. Meningitis associated with serial lumbar punctures and post-hemorrhagic hydrocephalus. J Pediatr 1986; 109(6): 1057-60.
  • Brouwer AJ, Groenendaal F, van den Hoogen A, et al. Incidence of infections of ventricular reservoirs in the treatment of posthaemorrhagic ventricular dilatation: a retrospective study (19922003). Arch Dis Child Fetal Neonatal Ed 2007; 92(1): 41-3.

İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması

Year 2013, Volume: 48 Issue: 3, 200 - 203, 01.10.2013

Abstract

Amaç: Yenidoğan döneminde ilerleyici hidrosefalinin varlığında ve şant cerrahisinin uygun olmadığı olgularda uygulanan tedavi yöntemlerinden biri boşaltıcı lomber ponksiyonlardır Beyin omurilik sıvısının yeterli boşaltılamaması ve uygulama güçlüklerinden dolayı daha kolay ve etkili olan ventrikül içi rezervuarlar aracılığıyla bu sıvının alınması belirli bir tedavi olmuştur Çalışmamızın amacı farklı nedenlerle ilerleyici hidrosefalisi olan ve rezervuar takılan olgulara ilişkin deneyimimizi aktarmaktır.

Gereç ve Yöntem: İki bin beş 2009 yılları arasında Yenidoğan Yoğun Bakım Birimi rsquo;mizde izlenen ve şant cerrahisi için uygun olmayan ve ilerleyici hidrosefali nedeniyle rezervuar takılan 18 olgu geriye dönük olarak incelendi Rezervuara ilişkin komplikasyonlar ve olguların ventriküloperitoneal şant gereksinimleri değerlendirildi.

Bulgular: Rezervuar takılan olguların 13 rsquo;ü erken doğmuş ortalama doğum ağırlığı 1542 plusmn;522 g; ortalama gebelik yaşı 29 9 plusmn;3 4 hafta beşi zamanında doğmuş ortalama doğum ağırlığı 3270 plusmn;679 g; ortalama gebelik yaşı 38 plusmn;0 7 hafta idi Olguların 11 rsquo;inde ventrikül içi kanama dördünde miyeloşizis üçünde doğuştan nedenler ldquo;Aquaduct rdquo; stenozu: 2 ldquo;Dandy Walker rdquo; malformasyonu: 1 hidrosefaliye neden olurken rezervuarların takılma zamanı ortalama 21 5 7 71 gün; takılı kaldığı süre ortalama 31 5 7 122 gün olarak bulundu İzlemde olguların 16 rsquo;sına 88 ventriküloperitoneal şant takıldı Rezervuar takılan olguların birinde cilt enfeksiyonu birinde cilt nekrozu saptandı Ventrikül içi kanaması olan üç olgu doğuştan hidrosefalisi ve kas hastalığı olan bir olgu tekrarlayan alt solunum yolu enfeksiyonuna bağlı doğum sonrası dönemde aspirasyon pnömonisi diğer doğuştan hidrosefalisi olan bir olgu ise çoklu organ yetersizliği nedeniyle kaybedildi.

Çıkarımlar: Ventrikül rezervuarı ilerleyici hidrosefalide beyin omurilik sıvısının boşaltılmasında kullanılabilen etkili bir yöntemdir Çalışmamız ilerleyici hidrosefalinin beyin parankiminde yaratacağı kalıcı hasarı önlemek amacı ile ventrikülo peritoneal şant takılamayan olgularda rezervuarın boşaltıcı lomber ponksiyonlara iyi bir seçenek olduğunu göstermektedir.

References

  • Kirkpatrick M, Engleman H, Minns RA. Symptoms and signs of progressive hydrocephalus. Arch Dis Child 1989; 64(1): 124-8.
  • Levene MI. Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child 1981; 56(12): 900-4.
  • Levene MI, Starte DR. A longitudinal study of post-haemorrhagic ventricular dilatation in the newborn. Arch Dis Child 1981; 56(12): 905Kreusser KL, Tarby TJ, Kovnar E, Taylor DA, Hill A, Volpe JJ. Serial lumbar punctures for at least temporary amelioration of neonatal posthemorrhagic hydrocephalus. Pediatrics 1985; 75(4): 713Randomised trial of early tapping in neonatal posthaemorrhagic ventricular dilatation. Ventriculomegaly Trial Group. Arch Dis Child 1990; 65(1): 3-10.
  • Marlin AE, Gaskill SJ. The etiology and management of hydrocephalus in the preterm infant. Concepts Pediatr Neurosurg 1990; 3: 67-78.
  • Rhodes TT, Edwards WH, Saunders RL, et al. External ventricular drainage for initial treatment of neonatal posthemorrhagic hydrocephalus: surgical and neurodevelopmental outcome. Pediatr Neurosci 1987; 13(5): 255-62.
  • Weninger M, Salzer HR, Pollak A, et al. External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery 1992; 31(1): 52-8.
  • Marlin AE, Rivera S, Gaskill SJ. Treatment of post-hemorrhagic ventriculomegaly in the preterm infant: Use of the subcutaneous ventricular reservoir. Concepts Pediatr Neurosurg 1988; 8: 15-22.
  • McComb JG, Ramos AD, Platzker AC, Henderson DJ, Segall HD. Management of hydrocephalus secondary to intraventricular hemorrhage in the preterm infant with a subcutaneous ventricular catheter reservoir. Neurosurgery 1983; 13(3): 295-300.
  • Volpe JJ. Intracranial hemorrhage: Germinal matrix-intraventricular hemorrhage of the premature infant. In: Volpe JJ, (ed): Neurology of the newborn. Philadelphia: Saunders, 1995: 403-63.
  • Yu B, Li S, Lin Z, Zhang N. Treatment of posthemorrhagic hydrocephalus in premature infants with subcutaneous reservoir drainage. Pediatr Neurosurg 2009; 45(2): 119-25.
  • Boynton BR, Boynton CA, Merritt TA, Vaucher YE, James HE, Bejar RF. Ventriculoperitoneal shunts in low birth weight infants with intracranial hemorrhage: neurodevelopmental outcome. Neurosurgery 1986; 18(2): 141-5.
  • Weiss MG, Ionides SP, Anderson CL. Meningitis in premature infants with respiratory distress: role of admission lumbar puncture. J Pediatr 1991; 119(6); 973-5.
  • Willis B, Javalkar V, Vannemreddy P, et al. Ventricular reservoirs and ventriculoperitoneal shunts for premature infants with posthemorrhagic hydrocephalus: an institutional experience. J Neurosurg Pediatr 2009; 3(2): 94-100.
  • Hahn YS, McClone DG, Raimondi AJ, et al. Surgical severe periventricular intraventricular hemorrhage and posthemorrhagic hydrocephalus. In: American Society of Pediatric Neurosurgery, (ed). Concepts in Pediatric Neurosurgery 1983; 66-80.
  • Hudgins RJ, Boydston WR, Gilreath CL. Treatment of posthemorrhagic hydrocephalus in the preterm infant with a ventricular access device. Pediatr Neurosurg 1998; 29(6): 309-13.
  • Kormanik K, Praca J, Garton HJ, Sarkar S. Repeated tapping of ventricular reservoir in preterm infants with post-hemorrhagic ventricular dilatation does not increase the risk of reservoir infection. J Perinatol 2010; 30(3): 218-21.
  • Smith KM, Deddish RB, Ogata ES. Meningitis associated with serial lumbar punctures and post-hemorrhagic hydrocephalus. J Pediatr 1986; 109(6): 1057-60.
  • Brouwer AJ, Groenendaal F, van den Hoogen A, et al. Incidence of infections of ventricular reservoirs in the treatment of posthaemorrhagic ventricular dilatation: a retrospective study (19922003). Arch Dis Child Fetal Neonatal Ed 2007; 92(1): 41-3.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Hülya Özdemir This is me

Hülya Bilgen This is me

Eren Özek This is me

İpek Akman This is me

Memet Özek This is me

Publication Date October 1, 2013
Published in Issue Year 2013 Volume: 48 Issue: 3

Cite

APA Özdemir, H., Bilgen, H., Özek, E., Akman, İ., et al. (2013). İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması. Türk Pediatri Arşivi, 48(3), 200-203.
AMA Özdemir H, Bilgen H, Özek E, Akman İ, Özek M. İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması. Türk Pediatri Arşivi. October 2013;48(3):200-203.
Chicago Özdemir, Hülya, Hülya Bilgen, Eren Özek, İpek Akman, and Memet Özek. “İlerleyici Hidrosefalisi Olan yenidoğanlarda ventrikül içi Rezervuar Uygulaması”. Türk Pediatri Arşivi 48, no. 3 (October 2013): 200-203.
EndNote Özdemir H, Bilgen H, Özek E, Akman İ, Özek M (October 1, 2013) İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması. Türk Pediatri Arşivi 48 3 200–203.
IEEE H. Özdemir, H. Bilgen, E. Özek, İ. Akman, and M. Özek, “İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması”, Türk Pediatri Arşivi, vol. 48, no. 3, pp. 200–203, 2013.
ISNAD Özdemir, Hülya et al. “İlerleyici Hidrosefalisi Olan yenidoğanlarda ventrikül içi Rezervuar Uygulaması”. Türk Pediatri Arşivi 48/3 (October 2013), 200-203.
JAMA Özdemir H, Bilgen H, Özek E, Akman İ, Özek M. İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması. Türk Pediatri Arşivi. 2013;48:200–203.
MLA Özdemir, Hülya et al. “İlerleyici Hidrosefalisi Olan yenidoğanlarda ventrikül içi Rezervuar Uygulaması”. Türk Pediatri Arşivi, vol. 48, no. 3, 2013, pp. 200-3.
Vancouver Özdemir H, Bilgen H, Özek E, Akman İ, Özek M. İlerleyici hidrosefalisi olan yenidoğanlarda ventrikül içi rezervuar uygulaması. Türk Pediatri Arşivi. 2013;48(3):200-3.